My sister called me the other day to ask if I had any recommendations on a Chiropractor in Texas for her husband, as I was walking her through who I think she should send her husband to I realized that I wish more people had this same knowledge when it comes to selecting a Chiropractor.

Of course I am biased when it comes to what I think makes a good Chiropractor but I think there are some commonalities when it comes to the few good ones out there. I’ll start with a short list of things I think are important and add my commentary at the end.

If they claim to correct subluxations and clear/free the bodies innate ability to heal itself, I would be very skeptical and steer clear.
If the Chiropractor takes X-Rays on every patient they see, I would again be very hesitant to see them.
I would encourage people to look for a Sports Chiropractor or DC with a CCSP or DACBSP distinction.
Look for a Chiropractor that offers more than simply adjusting the spine, some soft tissue and a focus on active care are equally if not more important.
Treatment times in general should be longer than 5-15 minutes.
Look for a Chiropractor who is familiar with the things you do.

So in the world of Chiropractors there are two big camps, those who practice what is called “straight” chiropractic and then those who are more “mixed” in the way they practice. What this means is that the “straight” chiros choose to only adjust the spine (some only work on the upper neck region) and the idea is they are realigning the spine, taking pressure off of nerves and allowing the body's innate ability to heal itself to be reestablished. This has somehow been eaten up by the general population of people but unfortunately there are few great scientific studies that support this type of treatment.

“Mixers” on the other hand tend to look outside of just the spine they will do some soft tissue work and spend time on active care. This is where there is much more backing from scientific evidence, some manual therapy plus active care for best patient outcomes. The “mixers” or “Forward Thinking” group of Chiros tend to look more towards evidence for treatment whereas the “straight” will look towards philosophy of treatment.

The second point I made suggests you shouldn’t see a Chiropractor if they regularly take X-rays of all patients. First, the evidence for imagining being reliable for diagnosing has become very poor. There are multiple studies on shoulders, low backs and even hips, when someone gets an image of these areas we could see actual damaged tissue but the patient could be reporting zero pain. The opposite is true, we could take an image and see nothing wrong yet the patient will report pain, does that mean specific structures aren’t responsible for pain? Not really, it just means that it is very hard to tell just by looking at an image if a structure needs helping or not. Not to mention each X-ray will expose you to a certain amount of radiation (although small) if it can be avoided it probably should.

Point three is one of my personal biases, I would first look to someone who recognizes themselves as a “Sports” clinician and there are a few distinctions Chiropractors can get to be recognized as such. One of those is a CCSP or Certified Chiropractic Sports Physician, another is a DACBSP or a Diplomate American Chiropractic Board of Sports Physicians. The CCSP is basically the first step to getting the DACBSP and requires extra hours learning more sport specific management of patients or events. I happen to have a Masters degree in sports medicine and that is another thing you could look for in your Chiropractor is to have additional degrees. I want to be clear here though, I know tons of Chiropractors who aren’t CCSP’s or have a Masters degree that are very good clinicians and would be considered some of the best in the profession.

Point four is similar to point one, but I just want to re emphasise that the best evidence for treatment of pain for a patient incorporates more than just passive treatment (simply adjusting or only manual therapy). In fact there has been more research suggesting that exercise is your best bet for treatment and if the Chiropractor doesn’t try and get patients to do some sort of active care then they probably aren’t doing what is best for the patient.

Point five here is again similar to my last point, but if there isn’t some sort of time dedicated to educating the patient on the mechanics of the situation or exercises that could benefit them then I don’t feel that Chiropractor is doing the absolute best care.

Finally, something that I feel strongly about is if you are going to see a Chiropractor or physical therapist or even your family doctor for that matter, I think there is a lot to be said for being able to understand the sport/activities that the patient does. For example if you do CrossFit or dance or garden or play basketball, wouldn’t you want your practitioner to be familiar with the demands of that thing? Just like there are specializations in the medical field, there are Chiropractors and physical therapists that understand the demands of different activities better than others. So look for that, do they incorporate things in their website or bio that you like and can relate to?

Ultimately the choice is yours, you can see who you want and spend your money where you like. My intention for this is to simply get you to ask why, why do you want to see someone? If you have been dealing with pain or dysfunction in an area don’t you want to best most comprehensive and evidence based approach? This blog isn’t too scientific in itself or the few things I selected to write about but I think if you as the patient are seeking that out these few things to look for will steer you in the right direction.

If you feel like you don’t move well or if you have been told you have specific movement flaws during different activities don’t worry! First, most people have different movement styles and that doesn’t mean that one movement is always better than another. Movement variability (different styles of performing a task) is ok and it even helps us learn new movements. The few times that specific movement really matters is when you are loading it up with higher forces than normal (lifting weights is the best example).

In these cases, it might be more beneficial to have “good” mechanics but learning those mechanics can sometimes be difficult or take a while to master. Well, there are a few ways in which you can try and become more proficient at moving and this is a technique I really like.

The technique that you can start to implement to help change your movement flaws is called Reactive Neuromuscular Training or RNT. It sounds fancy and cool but it is really pretty simple.

Here is my breakdown of the training approach:

Reactive- in response to.

Neuromuscular -the nerve and muscle system/unit.

Training- to practice

So what does this mean? Let’s use a squat as an example since it is the easiest.

If you squat and you see your knees cave in (see picture), most people would say that is a movement flaw. To try and correct this you can put some sort of extra resistance (such as a band) that actually pulls your knees into the fallen or caved in position. Sound a bit backwards? That’s the “reactive” part of the training.

If I were to try and push you over, your body would reflexively try and push back to keep from falling over. A similar thing happens when we put a band around the knees; your body will reflexively push out against it now that there is some resistance there.

Now that you know an example, you can apply that technique to just about any part of the body. The trick is trying to implement that into a way you can train it. Have you been told your foot falls in when doing different movements? Put a band around your ankle to pull the foot in while performing a single leg deadlift and see if that helps.

Hips shift right or left when squatting? Try pulling your hips further into the direction you shift to and see if your body naturally fights the resistance to get back to neutral.

All you are doing with RNT is providing a resistance in the direction of the movement flaw, then train that movement. Over time you should see that you don’t naturally fall into that flaw as often and you can use smaller and smaller cues or resistance to get the same “correction”.

Again, this is a simple trick that you can apply almost anywhere. If you have any questions about trying to correct your specific movement flaws, reach out to me and I would love to share my thoughts.

Choosing a Chiropractor: Where to start

Correcting your movement flaws with this simple trick